The neurobiology and consequences of epilepsy in the developing brain

Epilepsy is a disorder in which the balance between cerebral excitability a nd inhibition is tipped toward uncontrolled excitability. There is now clea r evidence that there are distinct differences between the immature and mat ure brain in the pathophysiology and consequences of seizures. Both the enh anced excitability of the immature brain compared with the mature brain and the unique pathologic consequences of seizures are related to the sequenti al development and expression of essential signaling pathways. Although the immature brain is less vulnerable than the mature brain to seizure-induced cell death, seizures in the developing brain can result in irreversible al terations in neuronal connectivity. Developing novel strategies to treat an d avert the consequences of seizures in children will require further under standing of the unique mechanisms of seizure initiation and propagation in the immature brain.